Company poised to lead market in 2019 for payer-provider collaboration technology augmented with accountable community networks to solve social determinants of health at scale

Closing a year marked by aggressive market expansion, HealthBI, a division of Equality Health, saw its CareEmpower® platform become the most widely used, payer-driven care coordination system today for both Medicare Advantage and Medicaid managed care members. As the first payer-agnostic system, CareEmpower is the provider’s central vehicle for meeting quality measures across multiple health plans.

At the beginning of 2018, CareEmpower was deployed in more than 63,000 clinical sites in all 50 states. By the end of the year, CareEmpower’s customer base had doubled, with Banner Health and Anthem just two examples of notable customer wins. Meanwhile, CareEmpower was deployed in over 8,000 additional clinical sites, which effectively makes HealthBI the largest provider of multi-payer care coordination technology today.

“It is now abundantly clear that a collaborative focus on keeping patients well is the key to improving poor health and costly overuse of acute healthcare services. HealthBI was among the first companies to recognize this trend to enable Medicare Advantage and Medicaid managed care plans and the providers in their networks with a shared cared coordination platform,” said Scott McFarland, President of HealthBI.

He added, “In 2018, we took this several steps further by making the CareEmpower platform payer-agnostic, which helps providers coordinate care for patients no matter their health plan. This early lead in developing a centralized platform for prioritizing quality-based workflow resulted in several significant new customers and strategic partnerships that position the company for continued market dominance in 2019 and beyond.”

Key ventures in the managed care market

CareEmpower is used by providers to proactively manage, coordinate and transition patient care for large complex patient populations—and to close the gaps in care that otherwise result in poor health outcomes, inequalities and high costs. The platform is typically purchased by health plans who in turn give it to the providers in their network to coordinate care across multiple specialties. Providers can also use CareEmpower to solve stubborn Social Determinants of Health via the platform’s social and cultural risk assessment tools and built-in networks of community-based organizations.

Earlier in the year, CareEmpower was tapped by the business services arm of one of the top three national healthcare insurers as the point-of-care platform for its network of Medicare Advantage providers; a partnership that has put HealthBI in front of the fastest-growing commercial healthcare plans today. CMS predicts record enrollment in Medicare Advantage plans in 2019 by almost 23 million enrollees–an 11 percent jump from 2018.

In October, HealthBI announced its CareEmpower platform would be coordinating care for a significant number of members in five of the seven Medicaid managed care plans under the state of Arizona’s new Complete Care mandate.

These plans include Banner-University Family Care Plan, Care1st Health Plan Arizona, Arizona Complete Health, Mercy Care, and UnitedHealthcare Community Plan. Under the new Complete Care model, Medicaid managed care plans in the state must join physical, behavioral health and community services together to treat all aspects of members’ healthcare needs.

Coming close on the heels of this last announcement, HealthBI announced it had formed a partnership with TAVHealth to create the technology infrastructure for solving the social determinants of health faced by our most vulnerable patient populations.

The partnership augments the CareEmpower platform into a scalable community care coordination platform that can be replicated in any geographic location.

Building the healthcare model of the future

HealthBI’s market activity in 2018 portends some of the most important trends shaping healthcare today. First, as more Baby Boomers age into Medicare, supplemental and commercial Medicare plans will play an increasingly important role in containing the cost and improving the quality of care for a generation that counts more than 75 million people. Care coordination technology that facilitates collaboration and provides a whole picture of member health will be essential for these plans.

The evolution of Medicaid into a model of value-based, whole person care is also driving the need for technology like the CareEmpower platform. It enables providers and managed care plans to work hand-in-hand with trusted community-based organizations to solve social determinants of health at scale.

“In 2018, we helped drive historic changes in healthcare. We expect these changes will improve health for millions of Americans in 2019,” McFarland concluded.

About HealthBI

Headquartered in Phoenix, Arizona, HealthBI, a company of Equality Health, was created by a team of industry leaders and physicians to fill the need for solutions that enable providers and engage patients for better quality outcomes. By arming providers and payors with real time insights and a platform to seamlessly collaborate across organizations and care settings, HealthBI prevents patients from slipping through the cracks. Today, the company’s care management and care coordination platform for population health management is the most widely deployed in the nation—used in over 63,000 clinical sites across 50 states. HealthBI customers have reported results that span from a 25 percent decrease in 30 day re-admits to a nearly 300 percent improvement in closing gaps in patient care. To learn more about HealthBI, visit www.healthbi.com and follow HealthBI on Twitter and LinkedIn.